Work List by Priority

Reminder List

Jacob – Restocking Patients Rooms Do not Enter if a Doctor is in the Room Do not Enter if the Door is Closed Do not Enter if there is a Crack in the Door…Whew solved that one

What if the Patient has Family Members or Friends in the Room? Jacob was thought of as rude Jacob was not cut out for a Hospital Setting Jacob was thought not to be able to be hired for this job (Even though his job performance was impeccable)

Dilemma

Dilemma When to fill the patients room if family members or friends were present! How about if Jacob creates a schematic of the room? The support person shares where people are in the room in green Jacob puts an X where he should and shouldn’t walk

Dilemma Share with Jacob what a T – Chart is about When you can walk in front and when you can’t Then ask Jacob to ask his team the two questions: -Should I ask them to Move -Should I come back later Jacobs team unanimously said come back later

T-Chart

Marty’s Work Plan at ETA Engineering Technology Associates, Inc Marty’s Work Plan at ETA

In-service about Autism

Schedule of Support

Communication Sheet

Time Sheet

Self-Management System

Utilizing MRS and Transition Coordinators as Facilitators of Work Place Case Conferences

Facebook Posts

Brian’s Work Plan

Chime System – Bus Cart/Dirty Dishes

Employee information about Brian

Systems Sheet

Dishes in the 3 Compartment Sink NEED TO CLEAN FINISHED

What Employees need to know about Brain

Break Area at Work Behind Restaurant Staff Concerned about Cars/Trucks Area of Pavement Behind Restaurant – Painted a Pacing Area Not going to leave area

Have you ever volunteered for any organization? Why did you continue to volunteer? Group Discussion

Natural Supports Maintenance Employee of the Month Work Talk After Work Celebrations League Opportunities Fantasy Football Sports Pools Lotto Pools

People with ASD must be Approachable Socially Appropriate Dress -Barbie Boots -Jelly Bean Jogging Suit Behavioral Issues -Stereotypical Behaviors Social Issues Picking Nose Spitting

The Network Do the natural supports go beyond the work environment? Personality of the Person with ASD Climate of the Employment Community Dan and the Casino Ryan’s Party

Develop an On-Line LINK Social Network Track Graduated LINKS Allow Networking Between LINKS Post Opportunities for Graduated LINKS by RCN Provide Parents List of Graduated LINKS by RCN Social Network will be Hosted by a Person with ASD

Imagine the Possibilities Co-Workers Understanding of ASD Community College Opportunities University Opportunities Semi-Independent and Independent Living Arrangements Social Opportunities Community Opportunities

Now For the Research! Natural Supports

Alternatives to Traditional Job Coaching Define Natural Supports in Terms of the Workplace Rather Than… Cultural (Environment) vs. Job Assessment Alternatives to Traditional Job Coaching Marc Gold & Associates marcgold.com

How Can We Look At Supporting People with ASD in Employment Opportunities…. Differently

Start with Least Amount of Support Not the Most Amount of Support Traditional Model Assumes a Job Coach – Most Restrictive

Least Amount of Support to Most Amount of Support Working independently without any supports or strategies Working independently with visual supports Working independently with self management plan and visual supports Working independently with self management plan, visual supports and job coach to train person to systems Working but dependent on job coach

Traditional Mindset Job Coach will Lead To… Working Independently without any Supports or Strategies

Rarely True with a Person with ASD Either Person with ASD becomes Dependent on the Job Coach Or Continues to Need Visuals and a Self Management Plan to be Independent

To Do This… Must Understand This…

Reconsideration of Job Analysis Focus on Cultural Analysis of the Employment Environment rather than a Focus on Job Analysis Marc Gold & Associates marcgold.com

Natural Supports – Two Powerful Forces that Affect the Success Features of Naturalness – Gain Access Individual Needs – Assure The Needs of the Individual are Met

7 Phase Sequence for Balancing Naturalness and Individual Needs Determine Natural Ways Determine Natural Means Identify Natural People Facilitate Successful Performance Support/Substitute for Natural People Suggest More Effective Natural Means Adapt/Modify Natural Ways Marc Gold & Associates marcgold.com

Determine Natural Ways Methods of Performance for Targeted Job Tasks Step by Step Procedures The Culture of the Workplace The Manner in Which Workers Interact The Managerial Style of the Setting All Other Natural Features which Describe the Unique Characteristics of Performance and Behavior Desired by the Employer Marc Gold & Associates marcgold.com

This Phase is Crucial… Brenda and Kent County Information for New Employee to Fit In Easier for Supervisors and Co-Workers to Provide Assistance and Troubleshoot Problems Due to the Similarity of Performance Marc Gold & Associates marcgold.com

7 Phase Sequence for Balancing Naturalness and Individual Needs Determine Natural Means Identify Natural People Facilitate Successful Performance Support/Substitute for Natural People Suggest More Effective Natural Means Adapt/Modify Natural Ways

Determine Natural Means Ask the Employer to Describe the Procedures Used Observe Teachings Done by Employees in the Setting Ask to be Taught How to Perform the Job Task by the Persons Who Would Naturally Assist the Jobs to be Performed Marc Gold & Associates marcgold.com

How Did You Learn How to Write an IEP?

7 Phase Sequence for Balancing Naturalness and Individual Needs Identify Natural People Facilitate Successful Performance Support/Substitute for Natural People Suggest More Effective Natural Means Adapt/Modify Natural Ways Marc Gold & Associates marcgold.com

Identify Natural People Identify and Enlist the Natural People Who Typically Support New Employees to Perform Their Jobs (600 Formalized P2P Support Programs) Most Novel Aspect of the Natural Supports for Traditional Providers of Supported Employment Services

In the Past…Job Developers Often Promised Employers… Job Trainers Would Provide all the Assistance Necessary for Successful Performance They Would Have No Investment in the Initial Training or Support of the Employee Job Trainers Would Act as an Interpreter for All the Information, Rules, Policies and Activities This Role Placed the Job Coach Between the Employer and the Employee

Not a Typical Model for an Employer/Employee Relationship Job Coach Employee

Unnatural dependence on an adult not associated with the environment Similar to Issues with the Over-reliance on the use of Paraprofessionals in the Schools Unnatural dependence on an adult not associated with the environment

This Practice Resulted in Isolation of Supported Employees in their Own Work Settings

7 Phase Sequence for Balancing Naturalness and Individual Needs Facilitate Successful Performance Support/Substitute for Natural People Suggest More Effective Natural Means Adapt/Modify Natural Ways Marc Gold & Associates marcgold.com

Facilitate Successful Performance (Ongoing Problem Solving Process) Initial and Ongoing Assistance to the Supported Employee Job Developers(Facilitators) Must Now Decide the Degree of Naturalness Which Will Be Used for Initial Training Strongly Suggested…Unless There Are Clear Indications to the Contrary, Natural Procedures Be Utilized Initially Marc Gold & Associates marcgold.com

Natural Supports and Case Conferences Weekly or Monthly Meetings Problem Solving Focus May Include the Person with ASD Teaching Support Strategies in the Case Conference that will Generalize to the Work Environment

Case Conference – Alex – 40 Minutes During Staff Lunch Time OT/PT Department – 23 Staff People Information about ASD in the Workplace Alex was in the case conference Referred to Alex for input frequently Questions from Staff Alex to answer first

Information about ASD in the Workplace Sections of Looking at ASD Differently Adult that pertain to Alex Literal Interpretation of Information Misunderstanding of Social Situations Responding to Others Needs Truth at all Costs

Questions from Staff in OT/PT Can we talk to Alex while he is working? Yes, of course in the same way you would speak with your colleagues. You might have to tell him the conversation is over. Can we ask Alex to get materials for us? Yes! Alex can retrieve materials needed during therapy sessions. Can we ask Alex to do things for us? Yes, but please use Alex’s Note Pad, located at the Aid Desk.

Shared Alex’s PT/OT Task List Remember to always be mindful of patients Remember Patient care comes first Remember to always use gloves when sanitizing and only when area and/or item is not in use Additional task are other things the staff need Alex’s assistance

Task Lists

Natural Supports and Case Conferences Weekly or Monthly Meetings Problem Solving Focus May Include the Person with ASD Teaching Support Strategies in the Case Conference that will Generalize to the Work Environment

Case Conference Information Sheet Each staff fills out the sheet at the beginning of the case conference The facilitator collects the sheets and determines if there are any patterns in the answers The information from the sheet generates the discussion using the board

Case Conference Information Sheet

Case Conference Mechanics and Outcomes Utilize meeting mechanics – always use the board Positives – Concerns – Brainstorming Information from the board is written on the Case Conference information sheet Copies are made for each staff member, person with ASD, and parent or guardian if appropriate

“ “Case Conferences” Overview of ASD Triad – Social, Communication, Restrictive Repetitive Theory of Mind Impact – How it looks in Work Setting Rude, Disrespectful, Etc. Answer Specific Questions about Behavior Looks Like Stalking/Doesn’t Know How to Enter Conversation Social Mistakes

Role and Rules of work

Work Rules

“ “Case Conferences” Overview of ASD Triad – Social, Communication, Restrictive Repetitive Theory of Mind Impact – How it looks in Work Setting Rude, Disrespectful, Etc. Answer Specific Questions about Behavior Looks Like Stalking/Doesn’t Know How to Enter Conversation Social Mistakes

Friends At Work A Friend A Role Model An Encourager Sense of Belonging Community Connection

(Not found in Callahan’s Document) Strongly Suggested…Unless There Are Clear Indications to the Contrary, Natural Procedures Be Utilized Initially People with ASD will make social mistakes…need an ongoing problem solving approach to the address the mistakes that will be made (Not found in Callahan’s Document)

Strong Rationale For the Job Developer (Facilitator) to Take Risk Allow Natural Means a Chance to Be Effective Marc Gold & Associates marcgold.com

Dignity of Risk Robert Perske The concept of “dignity of risk” is we allow our children, and ourselves, to make choices and the accompanying mistakes, failures… because this is how we learn. This is how we build our self-esteem and self-worth. Our Dignity.

What Does This Mean To Us Public Transportation – Brian Overnight/Sports Teams – Dan Washington D.C. Trip - Ryan

This Means… Never again will a Student with ASD be in such a protected environment. If mistakes are made, those mistakes can generally be fixed. With appropriate supports, Students with ASD must be given the same opportunities as their same aged peers. The Dignity of Risk needs to be a part of every decision educational teams are making for Students with ASD.

By Looking At Autism Spectrum Disorder Differently So…How are the Service Agencies Supporting Adults with ASD Going to Manage this Explosion… By Looking At Autism Spectrum Disorder Differently

A Reasonable Trade-Off… To Accept the Lessened Performance Through Naturalness Over That Available Through Powerful Training Procedures (W/O Parapro less quality work)

So Why Would This Be So Difficult… Because it is Not the Way We Have Done This in the Past

Constraints to the Initial Use of Natural Supports Job Developer and Employment Facilitator are Different People (Don’t have Skills) Impact of the Employee’s Disability Requires the Facilitator to Model Effective Techniques for the Natural Supports (Training/LINKS) Fragile Situations in Relation to Employer’s Low Expectations of Success (Get OUT) Modifications to Job Sites and/or Job Stations (Customized employment to meet needs) Marc Gold & Associates marcgold.com

7 Phase Sequence for Balancing Naturalness and Individual Needs Support/Substitute for Natural People Suggest More Effective Natural Means Adapt/Modify Natural Ways Marc Gold & Associates marcgold.com

Support/Substitute for Natural Supports (If We Change System This Issue Already Addressed) Demonstrate a More Powerful Technique Negotiate a Time for Discussion and Feedback with the Natural Supporter (Case Conferences) Offer Training Formally and Informally (Awareness of ASD) Shadow the Natural Support and Offer On-Going Feedback Marc Gold & Associates marcgold.com

7 Phase Sequence for Balancing Naturalness and Individual Needs Suggest More Effective Natural Means Adapt/Modify Natural Ways Marc Gold & Associates marcgold.com

Suggest More Effective Natural Means Reconsideration of the Natural Means Used by Employers to Teach and Motivate Employees to Perform Their Jobs Teaching Style of One Co-Worker May Differ Significantly from Another and Further Yet from a Supervisor Consideration…Various Strategies Which Seem to be Working and Who Uses Them Specific Suggestions to Specific Natural Supports…Each Different Marc Gold & Associates marcgold.com

Job Analysis Process in Supported Employment is a…Human Service Activity Designed to Assist Facilitators To: Organize the Information to be Performed by the Supported Employee Recognize the Natural Ways, Means and People Used by the Employer to Typically Perform and Teach the Job Develop a Plan for Balancing the Natural Features of Support Available at the Job Site Form Relationships Necessary to Accomplish the 7 Phase Sequence Marc Gold & Associates marcgold.com

Job Analysis Begins… After the Employer Has Given Approval for the Job to Begin and Before the Supported Employee Begins to Work

Why Would A Job Analysis Be Performed By A Human Service Provider? At This Time, The Funding and Responsibility for the Provision of These Supports Rest with Human Service Agencies Marc Gold & Associates marcgold.com

Summary Medium of Exchange Recruitment Training Maintenance Staff Responsibility Development of a Natural Support System

Where is your Team in the V3 Discovery Process

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